Provider Demographics
NPI:1215283130
Name:RIFAY, ASMA
Entity type:Individual
Prefix:
First Name:ASMA
Middle Name:
Last Name:RIFAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1664 IRONWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-6036
Mailing Address - Country:US
Mailing Address - Phone:770-364-9524
Mailing Address - Fax:
Practice Address - Street 1:1664 IRONWOOD RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-6036
Practice Address - Country:US
Practice Address - Phone:770-364-9524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-29
Last Update Date:2012-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA026671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist